Patients with autoimmune diseases often develop drug-induced hypersensitivity syndrome. This condition is also known as: Drug rash with eosinophilia and systemic symptoms (DRESS).
Dress can cause a severe reaction characterized by fever, rash, and eventually multi-organ failure. White blood cells known as eosinophils are released from the bone marrow in excessive amounts in this condition. Eosinophils release toxic granules that can injure organs.
DRESS typically occurs from 1-8 weeks after introducing the responsible drug. The reaction is immune-mediated involving macrophage and T-lymphocyte activation and cytokine release. The skin, blood cell system and the liver are most often involved. Vitamin D deficiency appears to be a risk factor in DRESS, which may explain its higher frequency in people with autoimmune diseases.